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中国一家单中心关于年轻大肝细胞癌患者肝切除的经验

Liver resection for young patients with large hepatocellular carcinoma: a single center experience from China.

作者信息

Liu Xi-yu, Xu Jiang-feng

机构信息

Department of surgery, Yiwu Affiliated Hospital of Zhejiang University School of Medicine, east building in huajiachi campus,kaixuan road 268, 310020 Hangzhou, Zhejiang, China.

出版信息

World J Surg Oncol. 2014 Jun 3;12:175. doi: 10.1186/1477-7819-12-175.

Abstract

BACKGROUND

To investigate retrospectively the clinicopathological characteristics and outcomes of young patients with large hepatocellular carcinoma after hepatectomy.

METHODS

From January 2003 to December 2012, a total of 153 patients with large hepatocellular carcinoma (HCC) who received liver resection were included in the study. The clinicopathological features were analyzed retrospectively. The perioperative data were compared between those aged <40 years (the young group) and those aged >40 years (the older group). Prognostic factors and long-term survival were evaluated.

RESULTS

The young group had more hepatitis B virus-related HCC than the older group (87.2% vs 66.3%, P = 0.031). In the young group, 15 patients (21.5%) were overweight (body mass index 25 to 29.9 kg/m2) or obese (body mass index ≥30 kg/m2), and 38 patients (45.8%) were overweight or obese in the older group (P = 0.032). Other clinicopathological characteristics were similar between the two groups. The perioperative data showed that the older group had more pulmonary infection after hepatectomy. Vascular invasion and high Edmondson-Steiner grade were the independent prognostic factors for long-term survival. There was no statistical difference between the young group and the older group in overall survival and disease-free survival (P = 0.109 and P = 0.087, respectively).

CONCLUSIONS

Liver resection for young patients with large HCC was safe and efficacious and should be recommended.

摘要

背景

回顾性研究青年大肝细胞癌患者肝切除术后的临床病理特征及预后。

方法

纳入2003年1月至2012年12月期间153例行肝切除的大肝细胞癌(HCC)患者,回顾性分析其临床病理特征,比较年龄<40岁(青年组)和年龄>40岁(老年组)患者的围手术期数据,评估预后因素及长期生存情况。

结果

青年组乙型肝炎病毒相关HCC患者比例高于老年组(87.2%对66.3%,P = 0.031)。青年组有15例(21.5%)超重(体重指数25至29.9kg/m²)或肥胖(体重指数≥30kg/m²),老年组有38例(45.8%)超重或肥胖(P = 0.032)。两组其他临床病理特征相似。围手术期数据显示老年组肝切除术后肺部感染更多。血管侵犯和高Edmondson-Steiner分级是长期生存的独立预后因素。青年组和老年组的总生存和无病生存无统计学差异(分别为P = 0.109和P = 0.087)。

结论

青年大HCC患者行肝切除安全有效,应予以推荐。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf1c/4049471/705643dce534/1477-7819-12-175-1.jpg

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